1. Pain while passing motions: Painfulness of the anus where there is a cut, is the most common symptom. The pain typically described by the patient is as cutting, shooting, agonizing, burning or even excruciating. It may last for a few hours after passing stool due to friction, fresh trauma, inflammation and infection. It would start soon while passing stool, at times, preventing the defecate. Children may avoid passing stool due to anticipated pain. If patient has consumed spicy food, there could be burning while passing stool; and afterwards. The pain may subside after a few minutes or few hours; to re-appear after the next call for passing stool.
2. Severe anal spasm (as a protective reflex)
3.Hard stool may cause friction on the wall of anus giving blood streaked stool. There may be frank bleeding after passing stool, which is likely to be bright red in color.
4. Itching, Discharge, swelling are common symptoms of chronic fissures.
Types of Fissure-in-ano
Fissure-in-ano may be acute (less than 6 weeks of duration) fissure or chronic (more than 6 weeks of duration) or recurring fissures.
Fissure-in-ano is largely considered as a medico surgical disorder. However, looking at it in the light of homeopathic medicine, it is medically correctible conditions. It is possible to avoid surgery using homeopathy, in most cases.
Causes of Fissure-in-ano:
Most common cause of the fissure-in-ano is constipation. Chronic constipation due to any reason (such as due to lifestyle, habitual, drug induced, due to pregnancy, etc.) leads to recurring abrasion or forceful rubbing of the anal mucosa, which leads to a fissure. The current theory also suggests that sphincter spasm and accompanying ischaemia ;may precipitate the development of fissures and prevent them from healing in some people. The other less common causes can be
When choosing the homeopathic remedy for fissure, the causative factors are always evaluated, and homeopathic medicine encompassing this cause is chosen. Remedy chosen in such way not only heals the fissure, but also does not allow the problem to recur.
- Following a bout of diarrhea or following passage of bulky or hard stools (especially in children)
- Multiple pregnancies
- Chronic use of purgatives
- Rarely, a fissure may be the manifestation of underlying disease e.g. Crohn's disease, ulcerative colitis, sexually transmitted disease, or cancer.
- Wrongly performed operation for piles
Diagnosis of Fissure
The diagnosis of fissure-in-ano is easy to make clinically and usually no complicated procedures are required to diagnose this condition. Examination by a proctoscope is better avoided. Physician will usually try to avoid putting any instrument in the anus, as the area is extremely sensitive and such examination can be very painful. In majority of cases, with careful evaluation of the symptoms and a close look at the anus, a diagnosis of fissure can be confirmed by a trained doctor.
On examination, the doctor may observe following:
- Spasm of the anus
- A split or cut in the posterior midline of the anal mucosa.
- Lateral fissures: If fissure is observed laterally, instead of posterior midline location of fissure, it may give hint to underlying diseases such as Crohn’s disease, ulcerative colitis, or sexually transmitted diseases. In such cases fissures are usually multiple and may have atypical appearance.
- Acute fissures (usually present for 6 weeks or less) are superficial with sharply demarcated edges.
- Chronic fissures (present for more than 6 weeks) are usually deeper and may have secondary features, including hardening of the edge of the fissure, a sentinal pile which looks like small skin tag, and hypertrophied anal papillae, etc.
Homeopathic Treatment for Fissure
Fissure-in-ano (anal fissures) finds an excellent treatment with homeopathy. Most cases heal with medicines and surgery can be avoided.
The Dr Shah's Homeopathy Treatment
Dr Rajesh Shah, M.D. has researched on a wide range of chronic diseases including Fissure-in-ano, for over 20 years. His research based molecules have international patents (pending as well as granted). His unique treatment protocol is made available to patients world over. At this point, there are patients from 180 countries under Dr Shah's care, which has been a world record.
The duration of treatment for Fissure-in-ano:
Most patients show significant improvement in about three to four weeks, in case of fissure-in-ano. The full length of treatment is usually for about four months. Some patients may need longer course of medication.
It is possible to avoid surgery in most cases, if timely homeopathic treatment is used.
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Future of Fissure
The vast majority of acute fissures resolve entirely within a short span of time, if there is no constipation or straining for the toilet.
If acute fissures are not properly managed, they become chronic. Chronic and non-healing fissure-in-ano may present as a complicated condition, especially when it is associated with resistant constipation,
1) Hemorrhoids (piles): Hemorrhoids are swollen, dilated veins of the rectum or anus. Hemorrhoids may be located at the beginning of the anal canal (internal hemorrhoids), or at the anal opening (external hemorrhoids).
2) Anorectal fistula: Anorectal fistula is a hollow tract (opening) leading from the anal canal or rectum to the skin through which watery pus drains.
3) Crohns disease: Crohn s disease is a chronic inflammatory process primarily involving the intestinal tract. It most commonly affects the last part of the small intestine (ileum) and/or the large intestine (colon and rectum). Also called as regional enteritis and ileitis.
4) Anorectal cancer: Cancer affecting rectum and anus.
5) Perianal abscess: Perianal abscess is a collection of pus outside the anus.
Chronic and recurring fissures may lead to permanent scarring or injury that prevents normal bowel movements.
Timely administered homeopathic medicines take care of acute and chronic fissures gently, effectively, and without producing any side effects.
Self Help For Fissure
1. Diet - As constipation is the main culprit behind fissure-in-ano, all steps to avoid constipation will help to a great extent. A high-fiber diet and extra fluids to prevent constipation are recommended. This means eating more fruits, vegetables, cereals, whole meal bread, etc. and drinking at least 8 glasses (12 cups) of water a day. Reduced intake of coffee and alcohol also helps.
2. To relieve pain Apply a warm towel to the area. Warm baths or Sitz baths also relieve pain. Use 8 inches of warm water in the bathtub, 2 or 3 times a day for 5-10 minutes. Do not expose the anal skin to hot bath water or hot shower water. Use only luke-warm water on this area.
3. Physical activity - No restrictions are necessary. In fact, physical activity reduces the likelihood of constipation.
4. To prevent infection, gently clean the anal area with soap and water after each bowel movement. Do not put any creams or ointments, cornstarch, talcum or other powder, witch hazel, or anything else on or into the anus.
5. To prevent recurrence - 1.Avoid constipation by drinking at least 8 glasses of water daily and eating a diet high in fiber. 2.Develop regular bowel habit. Do not suppress desire of passing stools as this results in hard and large stools, which usually produces injury to the anus. 3.Avoid straining at stools. 4.Avoid anal intercourse.